How to make a Health Insurance claim: All you need to know

Health Insurance is considered the most important aspect in an individual’s life because of the increasing health problems in people. As it is not compulsory to have one, but it provides financial support to not only to the policyholder but to the family as well. 

In the time of emergencies you can ask for a claim from the Insurance company, and to your honour the company will grant the claim after conducting some basic inspections.

Let’s glance at the process through which the policyholder can ask for claim from the Insurance company -

Intimation

There can be two types of hospitalisation - emergency and planned. In the case of Emergency hospitalisation, the insured has to send the intimation within 24 hours while for the planned hospitalisation you need to tell the insurer in advance about the upcoming expenses.

Documents

At the time of discharge, the policyholder should collect the discharge summary, copy of investigation reports, bills, prescriptions and pharmacy receipts.

Form

For claiming the coverage, the insured needs to fill the prescribed reimbursement form. Some of the sections are also filled by the hospital and the doctor who treated the policyholder.

Bank Details

At the time of submitting the claim, the policyholder needs to give all the bank details with IFSC. There are chances that a cancelled cheque can also be asked.

Submission

Documents (stated above) need to be submitted along with a claim form to the Third Party Administrator (TPA). The submission needs to be done after the discharge only.

Process

While all the formalities have been done by the policyholder, at the time of scrutiny of the documents thus submitted the insurer might call the insured for further records or receipts for providing the claim.

The process of claim might sound tedious but with the advancement of technology it can be done pretty easily and quickly. It is important to note that the policyholder should have old policy papers, as copies of them can be asked for at the time of claim. All the important papers need to be attained at the time of claim so that everything can be carried out smoothly.